|
|
|
NGS CoreSource Services
|
 |
|
Industry Trends, Plan Documentation and Employee
Communication Services
|
Benefit communication specialists and consultants will provide you with the latest on current and proposed legislative and compliance issues, guidance regarding industry trends such as wellness and preventive care, conduct training sessions and plan design meetings, draft summary plan descriptions, plan documents, amendments, and summaries of material modifications. These services are provided on an optional basis.
Unlike other claim administrators, NGS does not utilize unpublished guidelines to interpret coverage in areas where a plan is silent or language is ambiguous. Therefore, we recommend a plan design review session prior to the effective date of NGS administration. During the plan design review process, an NGS benefit communication specialist, client services representative and sales officer meet with client representatives to discuss plan design philosophies. Other provisions, including "focused" review provisions, plan maximums, deductible and out-of-pocket accumulations, large case management, coordination of benefits administration, auto no-fault coverage coordination, retiree coverage, and types of covered providers and facilities are also discussed. Finally, eligibility provisions are reviewed in detail. After completion, clients can elect to print the SPD or to make it available to participants on the internet via the NGS website.
For custom communications, NGS benefit communication specialists work with each client to develop necessary materials. Standard language is available on many topics and is available for review upon request.
Client plans are reviewed on an annual basis or in anticipation of legislative changes and as needed due to client request. NGS CoreSource also works with stop loss carriers to obtain pre-authorization on proposed amendments. Approved amendments are filed with the stop loss carrier. NGS will prepare a Summary of Plan Change or draft replacement pages for employee distribution.
NGS CoreSource keeps clients informed and up to date regarding legal and regulatory developments through regular updates on our website, newsletters, and special notices as required. Additionally, NGS provides on-site or web cast training of legal or regulatory changes to assist with client staff understanding of how such changes impact their plan and/or administration.
|
|
Medical Claims Administration